MEDICARE: BARBARA FISHER PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	6301002997	MI

General Provider Information

NPI Number	:	1245458280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA FISHER PHD

Provider Business Mailing Address
First Line	:	59100 MOUND RD
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094
Country	:	US
Telephone Number	:	586-323-3620
Fax Number	:	586-323-3568

Provider Business Practice Location Address
First Line	:	59100 MOUND RD
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094
Country	:	US
Telephone Number	:	586-323-3620
Fax Number	:	586-323-3568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/09/2007

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